Provider Demographics
NPI:1043520372
Name:EMBRIANO, ALANA MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALANA
Middle Name:MARIE
Last Name:EMBRIANO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200C OAK STREET
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033
Mailing Address - Country:US
Mailing Address - Phone:860-657-8868
Mailing Address - Fax:860-657-8802
Practice Address - Street 1:200C OAK STREET
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033
Practice Address - Country:US
Practice Address - Phone:860-657-8868
Practice Address - Fax:860-657-8802
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003177103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical